by Maria Troia —
Frozen shoulder, clinically known as adhesive capsulitis, is a state of stiffness in the shoulder that leads to decreased range of motion and pain in the glenohumeral joint, a ball and socket joint where the head of the humerus (the upper part of the arm) sits in a carved out area of the glenoid cavity of the scapula.
This versatile joint performs a wide range of movement and thus is highly adaptable. The glenohumeral joint has fewer stabilizing structures than other joints, which allows the shoulder to perform its various motions. However, this adaptability of the shoulder is also what makes it more vulnerable to injury.
Frozen shoulder sets in gradually, causing the joint to slowly immobilize. The connective tissue in the joint slowly tightens and becomes denser and more solidified, losing its elastic and pliable nature. Initially, most of us do not even notice the changes. When moving, the joint begins to hurt from the restriction that forms, and we instinctively limit our use of the shoulder, causing the body to lay down scar tissue in an innate attempt to guard and protect the joint.
The joint slowly becomes further immobilized as a result of this dense and fibrous tissue, limiting its function even more. Synovial fluid, which is designed to lubricate and nourish the joint, may leak out, complicating things more. The process causes adhesions to form around the joint capsule and freezes it — hence the term adhesive capsulitis or frozen shoulder.
The cause of frozen shoulder is unknown; however, a component of inflammation is always present. Sometimes there is a history of injury, bursitis, tendonitis or scar tissue from prior surgeries. The setup for the condition always happens gradually though, and most people do not even realize they are losing function until pain sets in.
According to a Harvard Medical School study, frozen shoulder seems to mostly affect women between the ages of 40 and 60.
Allopathic medicine often addresses the condition with NSAIDs or cortisone shots, both of which have side effects and may yield only temporary results because the underlying soft tissue imbalance is not corrected.
While all the muscles of the rotator cuff should be evaluated in frozen shoulder, the subscapularis is always a major player. The subscapularis is not a superficial muscle as it is located underneath the scapula, between the back of the ribcage and the underside of the scapula. It takes skill and correct positioning in order to manipulate it.
The John Barnes Approach to Myofascial Release (MR) is an alternative treatment that can have lasting effects within a few short sessions. A skilled therapist is trained to assess the structures involved with the frozen joint capsule and release them with sustained pressure on the area until the deep fascia in the joint releases, loosening up the frozen connective tissue, which encourages it to soften and melt.
As this tissue softens, pain-sensitive structures (nerves and blood vessels) are released from the web of dense fibers, joint range of motion returns and the client is back to an active lifestyle — free of pain.
Maria Troia, MSEd, LMT, NCTMB, CH is trained in the John Barnes Approach to Myofascial Release and AMMA Therapy®. She teaches continued education classes in AMMA Therapy® and is currently completing her Master of Science degree in acupuncture. Her bodywork practice is located in Old Town Scottsdale. www.EastWestHolistic.net or 480-313-6260.
Reprinted from AzNetNews, Volume 31, Number 4, August/September 2012.